What is hepatitis A and B?

The big hepatitis ABC

Hepatitis viruses cause liver inflammation and can also be transmitted during sex. However, you can easily protect yourself from infection. Hepatitis is an important topic for s.a.m health - but the focus is on protection and not on regular testing. That's why we don't offer hepatitis tests, but provide you with information on how to protect yourself.

What is hepatitis A?

Hepatitis A is rarely transmitted during sex, but in recent years there have been repeated outbreaks of hepatitis A in Europe among gay men and other men who have sex with men. Although the hepatitis A virus “only” causes an acute illness - the infection always heals itself - this acute illness in adults usually confines the patient to bed for weeks. The hepatitis A viruses are excreted with the feces, they are ingested with the mouth. Even the slightest traces are sufficient for infection, e.g. if a finger touches the anus during sex and comes to the mouth afterwards.

Otherwise, you can also become infected with hepatitis A (especially in countries with poor hygiene conditions) via uncooked vegetables or shellfish. In some regions, even tap water is not safe (which is also used for ice cubes, for example...). A vaccination against hepatitis A therefore not only offers protection during sex, but also when traveling.

Hepatitis A is rare in Germany, with around one in 100,000 people affected each year.

What is hepatitis B?

Hepatitis B is transmitted very easily during any kind of sex, the viruses are present in all bodily fluids. Another common way of transmission is by injecting drugs or other substances and sharing syringes. Infections with hepatitis B can become chronic and over the course of decades can lead to unnoticed shrinkage and scarring of the liver (cirrhosis) and even liver cancer. Whether people with hepatitis B are infectious depends on the amount of virus in their blood. Overall, hepatitis B is not rare, but fortunately it does not occur in large numbers: Around 10 cases per 100,000 inhabitants are currently reported in Germany every year.

What are the symptoms of hepatitis B?

Most people do not experience any symptoms when they become infected with the hepatitis B virus. If symptoms do occur, they are usually fatigue, nausea, upper abdominal discomfort or fever. Yellowing of the eyes and skin (“jaundice”, medically: “icterus”), combined with dark urine and light-colored stools, is rather rare. Chronic hepatitis B is usually only manifested by a slight increase in liver values.

Vaccination against hepatitis A and hepatitis B

You can't really protect yourself against hepatitis A and B with condoms during sex. But the good news is: there is an effective vaccination. For people who have a higher risk during sex, the statutory health insurance covers the costs (for both vaccinations), and for hepatitis A also for travelers to regions with an increased risk. If your family doctor's practice has doubts about this (which can sometimes happen), you can refer to the “vaccination guideline” of the Federal Joint Committee (www.g-ba.de). The guideline specifies which vaccinations are covered by health insurance for which people.

Since 1995, the Standing Vaccination Commission at the Robert Koch Institute has recommended the hepatitis B vaccination for infants. Anyone born after 1995 may already have been vaccinated.

However, you can also be vaccinated without a prior test. It is crucial for the success of the vaccination that you have received all the recommended doses.

As already mentioned, it is advisable to be vaccinated against hepatitis A at the same time with a combination vaccine.

This article was written by: Armin Schafberger - doctor and health scientist, as well as former medical officer of the German AIDS service organization.